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A Case of Methotrexate-Induced Road Rage?
from Ralph M.

I found your site while searching for mood swings Methotrexate (MTX). I have been injecting (subq) MTX to treat Crohn's after having tried other meds. The others worked for awhile, but here I am.

I've been taking MTX for about three months, once a week, 25mg.  I have been getting pretty pissed off (road rage to the point of flipping others off) and it occurred to me that I might blame it on my meds. I've never been completely docile, but I do feel as though I'm becoming an even bigger jerk than usual.

Thanks, -Ralph M.


Ed’s Response:  Thanks for adding your observation to our growing list anecdotes about MTX causing bad moods.  Search on “methotrexate and mood” from the FlakeHQ home page, or start with these three exchanges in the archives:

Drug references acknowledge the problem, but mood changes are pretty far down the list, as sampled here from WebMD.com....

Tell your doctor immediately if any of these unlikely but serious side effects occur: yellowing eyes/skin, change in the amount of urine, chest pain, dry cough, trouble breathing, calf pain/swelling, vision changes, irregular heartbeat, muscle weakness, mental/mood changes, seizures. [emphasis added; http://www.webmd.com...]

I guess it boils down to this question:  How bad are the bad moods and are they bad enough to suggest not taking MTX?  I’m sure derms hate to have to ask that question because (biologics aside for a moment), MTX has long been a flaker’s “best bet” systemic.  At the right dosage and with the right precautions ongoing, MTX can be used with predictable safety for long periods of time and this drug  — virtually alone among the oral systemics for psoriasis — works admirably on BOTH psoriasis and psoriatic arthritis.

Fortunately, flakers now have biologics to consider.  These are a different type of systemic and they must be injected.  (MTX often IS injected, but it’s also available orally.)  Some of the biologics work well on both skin and joint P.  Right now they’re awfully expensive ... but they’re sensational nonetheless.

You aren’t a flaker, Ralph, but I believe some of the biologics flakers use are also used for Crohn's.  You might want to ask your doctor about Enbrel, Humira or Remicade, if you haven't already.  As one of many in the autoimmune disorder pantheon, I can’t imagine Crohn’s withOUT a biologic countermeasure.

Best of luck to you.  -Ed

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